Antibiotics

Author Question: How Do You Develop a Vaccine From Blood?

/ Jordyn Redwood / Leave a comment

Ruby Asks:

I’m currently writing a sci-fi story where a pharmaceutical company has created something that could possibly cure any disease and behaves similar to a virus. Unfortunately, it falls into the wrong hands and is used to harm people. It is decided that a vaccine could help if developed from someone’s blood who carries antibodies to this substance.

Can a vaccine or antidote be made using a blood sample? Also, what would be the proper term for this? Is it a vaccine, antidote, or a serum?

Jordyn Says:

Hi Ruby! Thanks so much for sending me your question. This was pretty fun to research as I learned quite a few new things.

First, let’s define these three terms: vaccine, antidote, and serum.

A vaccine is a “preparation used as a preventive inoculation to confer immunity against a specific disease, usually employing an innocuous form of the disease agent, as killed or weakened bacteria or viruses, to stimulate antibody production”.

An antidote is a “medicine or remedy for counteracting the effects of a poison, disease, etc.”

Blood serum is the substance that remains after the blood forms a clot. Serum is the liquid that “blood cells move through”. It is used for the creation of antiserum. “Because blood serum contains antibodies as well, doctors can also use serum samples to develop what is called antiserum: essentially, blood serum containing resistances to specific illnesses and ailments. When transferred into a non-resistant patient’s bloodstream, antiserum allows that patient to gain resistance to illnesses they may have otherwise been vulnerable to.”

A vaccine is usually considered to be a preventative– the person has never had the disease and they get inoculated to keep them from getting it. This would be diseases like measles and mumps.

An antidote usually reverses the effects of a medication or poison and not a biological agent. For instance, Narcan, given to reverse the effect of an opioid overdose could be considered an antidote. Medical people refer to these medications sometimes as reversal agents.

An “antiserum” would be the best term for you to use, as this is giving someone antibodies who is currently infected with the disease. For instance, Dr. Kent Brantly, who contracted Ebola while providing medical aid in Liberia, was treated with antiserum.

So, ultimately, you would need to research how an antiserum is developed. Generally laboratory animals are used and then exsanguinated to be able to collect large quantities of antiserum. So– if you want this character to live– this may not be a good choice for your story. Though, you as the author could also use the death of this character to create conflict in your story, too.

For further articles on developing antiserum you can look here and here.

Best of luck!

Author Question: Treating Injuries Related to Torture 2/2

/ Jordyn Redwood / Leave a comment

Today, we’re wrapping up Taylor’s questions about treating injuries related to torture. You can find Part I here.

Question #2: She was whipped/flogged, and has wounds from that across her back. Her shirt is torn, and dried blood makes the fabric stick to the wounds, which is (obviously) painful. How long does it take for mild infection to set in? (Nothing major – no blood infection, sepsis, etc. Just the beginning signs – redness, swelling, warmth, etc.)  How would the wounds be treated? Antibiotics? Cleaning the wounds – how is that done? Can they be stitched?
Jordyn Says: These wounds will need to be cleaned for sure. To get stuck material from wounds we generally saturate them with saline to dissolve the blood and peel away the fabric. I did a recent post specifically about wound infections but on the short side is 12 hours. More commonly is 48 hours and considering her condition, wound infection is going to be a big concern. They cannot be stitched up.

Here is another post I did on stitches but outside time frame for stitching someone up is 24 hours and that is only if the wound is super clean which these would not be. Taking her to the OR for wound cleaning, debridement and dressing placement might be an option if they are extensive. They could do a better job with better pain control. The reason they can’t be stitched is concern for infection– we don’t want to trap pus/germs in a wound. Better to let it drain out. They’ll want to be sure she’s had a tetanus shot within the last five years. If not, she’ll get a booster. Antibiotics are probably warranted in her case– something for skin infections like Keflex. 

Question #3: When the soldiers rescue her from the hospital, how do they move her? She doesn’t have a spinal injury; she’s able to sit up and move in bed. Lying on her back on a stretcher wouldn’t be very comfortable. I guess she would have to lie on her side (the one that isn’t bruised and battered). Are there any other precautions they would need to take?
Jordyn Says: If they aren’t concerned about spinal cord injury than transporting her in a “position of comfort” is reasonable but she’d still have to be secured in seat belts some way.   
Question #4: How long do cracked ribs typically take to heal? She was kicked and/or stepped on by her captors, and has 1 or 2 cracked or broken ribs. If they are only cracked and bruised, if she was given some sort of wrap/brace, is it plausible that she would be able to go “out in the field” again after 2 weeks or so? She won’t be jumping out of helicopters, leaping tall buildings in a single bound, or anything like that – she’ll be interrogating suspects, maybe running for a bit in a foot pursuit, and will have some involvement (to be determined) in the take down of a very bad guy near the end of the book.
Jordyn Says: Cracked ribs usually take six weeks to heal. Here is some information on treatment of cracked ribs. Wrapping cracked ribs is not recommended anymore. We want the patient to be taking deep breaths so they don’t develop pneumonia. Wraps inhibit this. Cracked ribs are painful but not an unstable fracture so she can interrogate suspects and run but it will be quite painful and she’ll have decreased stamina for sure. A take down will be quite painful too because it will be hard to protect the area. 
Hope this helps and thanks so much for your questions! Best of luck with your book. 

Author Question: Treating Injuries Related to Torture 1/2

/ Jordyn Redwood / Leave a comment

Taylor Asks:

I have some character injury questions that I could use your help with, if you don’t mind! I contacted you last year with a bunch of questions about car crashes and injuries for another book that I was working on, and you were a tremendous help. I have some questions for this story, and thought I’d reach out to you again.
This story is a political thriller. One of my characters (Erin) is an American government agent who is ambushed and kidnapped by an Iraqi insurgent/terrorist leader while working in Iraq. He took her for two reasons. One is that he wants to use her as leverage/a bargaining chip to get what he wants. The other, more significant, reason is revenge. John (her current partner/coworker) had been a member of the US Army Special Forces. During a mission in the Middle East, he killed a fairly high-ranking terrorist who was responsible for the deaths of several US military members. That happened to be this man’s brother. Now this man has taken Erin, and plans to kill her – he wants John to know the pain of losing a loved one, and plans to make them both pay for John’s “crimes.”
One of her guards helps her escape after three or four days. He can’t deliver her back to the Americans, so he takes her to a local hospital and hands her over to the staff there for medical care. She is then rescued by the military a few days later. 
Iraqi insurgents are well known for their methods of torture and brutality to their captives. Fortunately for Erin, she was spared the worst of it; all things considered, they didn’t treat her TOO terribly.
Question #1: She’s hungry and dehydrated (they gave her very little food and water.) Other than IV fluids and adequate food and water after she is rescued, is there anything else that would need to be done?
Jordyn Says: In a time frame of four days, yes, she is likely dehydrated but she shouldn’t be terribly malnourished. A couple of liters of fluid (Normal Saline or NS) should get her feeling much better. Than some fluids that have some sugar and electrolytes in it at maintenance until she’s eating well and peeing well.  

We’ll continue with the remainder of Taylor’s questions tomorrow!

Treatment of Infected Wounds

/ Jordyn Redwood / Leave a comment

This post is in direct response to a question from Sue Harrison about taking care of infected wounds. What exactly is the treatment protocol.

Treatment of infected skin wounds is usually one of the easiest things we can do from a medical perspective. Unless it’s a superbug which is another concern entirely– but we’ll keep it simple for this post.

Here’s a short list of the treatment protocol.

1. Keep the wound from getting infected.  This boils down to a couple of things. In the ER– doing good wound irrigation for things like road rash and lacerations. Washing wounds physically removes the bacteria. If the bacteria aren’t present– they can’t fester to produce infection. Once the wound is cleansed– apply a topical antibiotic (like Neosporin or equivalent) to stem infection from developing.

2. Dressings should be changed once or twice daily. Unless it’s saturated– it can be left alone. The more things are mucked with– sometimes the more apt they are to become infected. You introduce more bacteria by touching.

Okay– say you’ve done all those really great things and it STILL gets infected.

One– is it really infected? Sometimes, people assume that mild redness is infection (this should only be 1-2mm around the wound edges) when it really is normal healing process. If the redness extends beyond 1-2mm– then there is more concern for infection.

Other signs: pain, swelling, pus draining, foul smell, red streaks running from the wound, swollen lymph nodes near the area, and fever.

Treatment:

First question: Should the wound/abscess be drained? Drainage is good because, just like irrigation above, it removes the bacteria. Some MRSA wounds are being managed just this way– with just drainage and no antibiotics– which is good to help prevent more resistant strains of bacteria from forming.

Second question: Place on oral antibiotics– but which one? This will be a good one to run by a doctor if it is important for the integrity of your ms. The most common one for surface skin infection is Keflex. But for abscesses– maybe something more along the lines of Clindamycin.

Sue– hoped this helped!!